Tenth Five Year Plan

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Five Year Plan is defined as any plan for National economic or industrial development specifying goals to be reached within a period of five years.

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PRESENTED BY A.RIGHTKUMARI DEVI LECTURER M.M.COLLEGE OF NURSING TENTH FIVE YEAR PLAN

INTRODUCTION:

INTRODUCTION The were conceived to re-build rural India, to lay the foundation of industrial progress and to secure the balanced development of all parts of country. The Tenth Five Year plan marks the return of visionary planning to India after a long interregnum of cautious optimism. During the past two decades, India has no doubt been one of the ten fastest growing economies in the world, but we cannot be content with that.

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1928 1950 Origins of tenth five year plan

ORIGINS / BACKGROUND OF THE TENTH FIVE YEAR PLAN:

ORIGINS / BACKGROUND OF THE TENTH FIVE YEAR PLAN Five year plans were first introduced in the erstwhile Soviet Union in 1928 for controlled and rapid economic development. Much of the Soviet Industrial successes were a result of the implementation of its five year plans. In 1950, India’s prime minister Jawaharlal Nehru, impressed by the soviet system, adopted five year plans as a model for economic development, and established the planning commission which was to act independent of any cabinet and was answerable only to the prime minister, who is also chairperson of the commission.

Contd…:

Contd… Draft plans were to be approved by the National Development Council, comprising the planning commission and the chief ministers of all states. An approved plan is then passed by the Cabinet and then in parliament. The benefits of five year planning, especially in a country as big and unpredictable as India have been questioned by many, and it has often been seen that targets are not met. After the Ninth five year plan this method has still not been able to successfully get rid of poverty and the cost overruns in failed or incomplete public sector projects were often too high. So planning commission has started 10th five year plan.

DEFINITION OF FIVE YEAR PLAN:

DEFINITION OF FIVE YEAR PLAN Five Year Plan is defined as any plan for National economic or industrial development specifying goals to be reached within a period of five years. (Random House Dictionary)

AIM OF TENTH:

AIM OF TENTH The primary aim of the 10th Five Year Plan is to renovate the nation extensively, making it competent enough with some of the fastest growing economies across the globe and meet the United Nations Millennium Development Goals (MDG) targets

MILLENNIUM DEVELOPMENT GOALS (MDG):

MILLENNIUM DEVELOPMENT GOALS (MDG)

OBJECTIVES / TARGETS:

OBJECTIVES / TARGETS The main objectives of the 10th Five Year Plan were: Reduction of poverty ratio by 5 percentage points by 2007 and 15 percent by 2012 Providing gainful and high- quality employment at least to the addition to the labour force

OBJECTIVES / TARGETS Contd…:

OBJECTIVES / TARGETS Contd… All children in India in school by 2003; all children to complete 5 years of schooling by 2007 Reduction in gender gaps in literacy and wage rates by at least 50% by 2007

OBJECTIVES / TARGETS Contd…:

OBJECTIVES / TARGETS Contd… Reduction in the decadal rate of population growth between 2001 and 2011 to 16.2% Increase in Literacy Rates to 75 per cent within the Tenth Plan period (2002 to 2007)

OBJECTIVES / TARGETS Contd…:

OBJECTIVES / TARGETS Contd… Reduction of Infant mortality rate (IMR) to 45 per 1000 live births by 2007 and to 28 by 2012 Reduction of Maternal Mortality Ratio (MMR) to 2 per 1000 live births by 2007 and to 1 by 2012

OBJECTIVES / TARGETS Contd…:

OBJECTIVES / TARGETS Contd… Increase in forest and tree cover to 25 per cent by 2007 and 33 per cent by 2012 All villages to have sustained access to potable drinking water within the Plan period

OBJECTIVES / TARGETS Contd…:

OBJECTIVES / TARGETS Contd… Cleaning of all major polluted rivers by 2007 and other notified stretches by 2012 Economic Growth further accelerated during this period and crosses over 8% by 2006.

FOCUSES DURING TENTH FIVE YEAR PLAN:

FOCUSES DURING TENTH FIVE YEAR PLAN Reorganization and restructuring the existing government health care system including Indian system of Medicine and Homeopathy Development of appropriate two way referral systems Building up an efficient and effective logistic system

FOCUSES Contd…:

FOCUSES Contd… Horizontal integration of all aspects of the current vertical programmes including supplies, monitoring, information education, communication and motivation, training administrative arrangement and implementation. Improvement in the quality of care at all levels and settings. Evolving treatment protocols for the management of common illness and diseases – promotion of rational, use of diagnostic and drugs.

FOCUSES Contd…:

FOCUSES Contd… Evolving, implementing and monitoring transparent norms for quality and cost of different health care in different health settings. Exploring alternative systems of health care financing including Improving content and health quality of education of health professionals and Para professionals

FOCUSES Contd…:

FOCUSES Contd… Skill up gradation of all health care providers through Continuing Medical Education and reorientation programs. Research and development to save major health problems and emerging diseases. Building up a fully functional, accurate health management information system. Building up an effective system of disease surveillance and response to at all levels .

FOCUSES Contd…:

FOCUSES Contd… Strengthening and sustaining civil registration, sample registration system, and improving medical certification of death. Improving the efficiency of the existing health care system in the government, private and voluntary sectors and building up appropriate linkages between them. Increasing the involvement of voluntary and private organization, self help groups and social marketing organization to improve access to health care.

FOCUSES Contd…:

FOCUSES Contd… Improving intersectoral coordination Devolution of responsibilities and funds to Panchayati Raj institutions. Improving the safety of the work environment Developing capabilities at all levels for emergency and disaster prevention and, management.

FOCUSES Contd…:

FOCUSES Contd… Effective implementation of the provision for food and drug safety. Screening for common nutritional deficiencies especially in vulnerable groups and initiating appropriate remedial measures.

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INITIATIVES DURING TENTH FIVE YEAR PLAN

HEALTH CARE SYSTEM:

HEALTH CARE SYSTEM For Rural Areas:- In the 10th plan health system reforms has been suggested to improve health services that include: Strengthening and appropriately relocating Sub center/ PHCs Merger, restructure, relocating of taluk, sub divisional and rural hospitals, dispensaries and block level PHCs ; integrating them with the existing infrastructure to fill the gap Utilizing fund from the Basic Minimum services , additional central assistance, Pradhan Mantri Gramodaya Yojana to fill critical gaps in manpower and facilities

Rural Areas Contd…:

Rural Areas Contd… Easy appointment of Doctors for PHCs Reducing the use of mobile health clinics as they are expensive. Hand over of PHCs to NGOs. Training of MBBS in certain specialties (Obstetric, anesthesia, radiology) to fill the gap in specialist in first referral units. Improving the logistics of study of drugs and consumables.

For Urban Areas:-:

For Urban Areas:- Urban primary health care institutions providing health and family welfare services to the population within 1-3 Km of dwellings by recognizing the existing institutions and linking them to secondary and tertiary care institutions are envisaged.

Urban Areas Contd…:

Urban Areas Contd… Secondary health care institutions strengthened by seeking the World Bank loans and building up of referral services in tenth plan Tertiary health care institutions were suffering from resource crunch. Efforts were made to recover cost from people above the poverty line. This help autonomy and encourage decentralized planning.

HEALTH CARE INFRASTRUCTURE:

HEALTH CARE INFRASTRUCTURE Priorities in tenth five year plan were Progress in strengthening of physical infrastructure Functional improvements in terms of patient care Improvement in different components of care-hospital waste management, disease

Priorities Contd…:

Priorities Contd… Surveillance and response, HMIS etc. Operationalisation of cost recovery through user charges from people above poverty line while ensuring that people below the poverty line do have access to health service free of cost Efforts currently underway to make the programme sustainable so that it remain fully functional after project period

DEVELOPMENT AND USE OF APPROPRIATE TECHNOLOGIES:

DEVELOPMENT AND USE OF APPROPRIATE TECHNOLOGIES Efforts for the development and testing of inexpensive technologies for weighing, measurement of blood pressure, hemoglobin estimation, and hand held data entry machines to improve HMIS to continue to receive support.

PUBLIC PRIVATE PARTNERSHIP:

PUBLIC PRIVATE PARTNERSHIP Continuing medical education to update the knowledge and skills of practitioners, evolving and implementing standards for quality of care and operationalization of an appropriate grievance redressal mechanism. Appropriate policy initiatives to involve all sectors to provide quality care at affordable cost especially for poor section of society , monitor their implementation, regulations and contractual obligations , promote excellence and ethics and punishment for professional misconduct were envisaged.

QUALITY AND ACCOUNTABILITY IN HEALTH CARE:

QUALITY AND ACCOUNTABILITY IN HEALTH CARE During the tenth plan quality control concepts and tools were introduced into every aspect of health care in order to ensure the defined and institutionalized norms , accountability and responsibility and with affordable cost for individual and the country as a whole.

HEALTH MANPOWER DEVELOPMENT:

HEALTH MANPOWER DEVELOPMENT Reorient the graduate and post graduate medical and paramedical course to enable the students to become competent professionals who can effectively implement programs aimed at improving the health status of the population. There is a need of University of Health Sciences in all the states. In-services training courses should be encouraged. Information technology used appropriately and all libraries with networking need to be strengthened. Telemedicine used for linking tertiary institutions of northeast with super specialty institutions.

HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS):

HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS) Efforts were made to ensure that effective two ways management information system is built up throughout the country using currently available information technology tools. A reliable sustainable database for mortality and morbidity was needed. For which disease surveillance was strengthened.

INFECTION CONTROL AND WASTE MANAGEMENT IN HEALTH CARE SETTINGS:

INFECTION CONTROL AND WASTE MANAGEMENT IN HEALTH CARE SETTINGS Hospital infection control and waste management incorporated as an essential routine activity in all health care institutions at all levels of care.

HORIZONTAL INTEGRATION OF VERTICAL PROGRAMS:

HORIZONTAL INTEGRATION OF VERTICAL PROGRAMS Horizontal integration of National leprosy elimination and tuberculosis control programs has been initiated. The pace of integration increased for such convergence for other programs also.

PREVENTION AND MANAGEMENT OF NON-COMMUNICABLE DISEASES:

PREVENTION AND MANAGEMENT OF NON-COMMUNICABLE DISEASES Many non-communicable diseases control programs were started by various institutions and efforts made in following areas Well structured IEC and motivation for primary and secondary prevention, Reorientation and skill up gradation of health care providers, Referral linkages between primary, secondary and tertiary institutions,

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Production and provision of drugs, Rehabilitation of disabled persons, Development of hospices for care of terminally ill people, Creation of an epidemiological database. Special efforts made for accident and trauma management during 10th plan.

ENVIRONMENTAL HEALTH:

ENVIRONMENTAL HEALTH Priority was expressed for monitoring and alleviation of pollution, creation of database, and epidemiological studies on the impact of biomass fuel on the health status, impact of noise pollution, production of cleaner fuels, and development of biomarkers.

OCCUPATIONAL HEALTH:

OCCUPATIONAL HEALTH Following areas were identified under the 10th plan : Establishment of norms for work environment in all sectors, Monitoring the work environment for pollution Monitoring of health status of workers, Intervention aimed at prevention, early diagnosis detection, and effective management of health problems of workers.

DRUGS-PRODUCTION, QUALITY & SUPPLY:

DRUGS-PRODUCTION, QUALITY & SUPPLY Efforts made to cover all states with expanded and strengthened essential drug programs, adopt an online inventory control program for procurement and supply of drugs, and establishment of a system to monitor cost, quality, and availability and use of drugs.

INFORMATION, EDUCATION, COMMUNICATION & MOTIVATION:

INFORMATION, EDUCATION, COMMUNICATION & MOTIVATION Review existing training program and making them more relevant. Integrate the various health education programs under different vertical program so that health personnel at each level of care provide comprehensive IEC to the population. Involve PRIs and NGOs in health promotions/education and IEC & M. Ensuring the involvement of non-formal leaders in the community in order to make health promotion/education and IEC & M a people’s movement.

PUBLIC HEALTH:

PUBLIC HEALTH Every effort made to ensure that policy makers, program managers, health care providers, and people themselves internalize and support the concept of public health and contribute towards attaining the public health goals.

HEALTH SYSTEM RESEARCH AND BIOMEDICAL RESEARCH:

HEALTH SYSTEM RESEARCH AND BIOMEDICAL RESEARCH Priority was given to health system research for improving service delivery and coverage as well as operational research aimed at improving access to technological advances. Basic and clinical research leading to development of products, drugs, vaccine for prevention, diagnosis and management of illnesses especially major health problems for which currently there was no effective care available were encouraged.

HEALTH CARE FINANCING:

HEALTH CARE FINANCING During the 10th plan health insurance/health maintenance organizations were reviewed and suitable models were replicated. In order to encourage healthy lifestyles, a yearly ‘no claim bonus’ adjustment of the premium could be made on the basis of previous year’s hospitalization cost reimbursed by the insurance scheme.

STRATEGY:

STRATEGY Following are the Strategies of the 10th Five Year Plan approved by the National Development Council (NDC): • Emphasis to be placed on completion of partially completed or on-going projects and upgradation of existing capital assets before starting new projects • Rapid privatization of Public Sector Enterprises (PSEs), particularly those, which working well below capacity • The policy of disinvestment of public sector undertakings should be pursued so as to enable the realization of Rs 16,000 crore per annum to finance the plan

STRATEGY Contd…:

STRATEGY Contd… • Progressive reduction in fertiliser subsidy as well as elimination of petroleum subsidy • Food subsidy better targeted through targeted public distribution system and specific programmes for the poor like Food for Work Programme • All villages to have sustained access to potable drinking water within the Plan period

STRATEGY Contd…:

STRATEGY Contd… Legal and procedural changes for facilitating quick transfer of assets, including such measures as repeal of Sick Industrial Companies (SPecial Provision) Act (SICA), introduction of a bankruptcy law, facilitating foreclosure, accelerating judicial processes Lower tariffs on imports to remove anti-export bias

STRATEGY Contd…:

STRATEGY Contd… Improving tax/GDP ratio of the Centre and states through inclusion of services in tax base, removal of tax exemptions and concessions, harmonization of tax rates, tightening of tax administration, and adopting an integrated VAT regime Reduction of budget-based subsidies by raising user charges of departmental services, reducing expenditure by cutting administrative and establishment cost and privatization

STRATEGY Contd…:

STRATEGY Contd… Enacting a 'Fiscal Responsibility and Budget Management' bill under which borrowings shall be restricted to attain a non-rising debt to GDP ratio from current levels in order to reduce the burden of interest payments Improving internal resources of states by implementing power sector reforms and reducing the burden of contingent liabilities on state budgets through a legislative or administrative ceiling on the issue of state guarantees

STRATEGY Contd:

STRATEGY Contd Simplifying laws and procedures for investment • Eliminating inter-state barriers to trade and commerce Reforming development financial institutions for long- term financing of small and medium enterprises Removal of government and Reserve Bank of India restrictions on financing of stocking and trading

STRATEGY Contd…:

STRATEGY Contd… Calibration of the cost of borrowed funds for enhancing competitiveness • Exemptions and concessions that distort the tariff structure should be eliminated • Improvement of the operational efficiency of railways and power sector units Reduction in staff strength and constitution of a pension and amortization fund to make committed payments like terminal benefits and debt servicing self-financing

STRATEGY Contd…:

STRATEGY Contd… Rationalisation of Centrally Sponsored Schemes (CSSs) and Central Sector Schemes (CSs) using zero based budgeting Railway Tariff Regulatory Authority needed to oversee the pricing of passenger and freight traffic services Opening of civil aviation sector and setting up a regulatory framework for the sector Adoption of integrated approach to improvement in agriculture sector by utilising waste and degraded lands

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ACHIEVEMENTS DURING THE PLAN PERIODS

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1. Primary health centers 23,236 2. Sub centers 146.026 3. Community health centers 3,346 4. Total beds 9,14,530 5. Medical colleges 242 6. Nursing colleges B.Sc.(N) colleges M.Sc.(N) colleges 399 54 7. Nursing Schools ANM Training Schools GNM Training Schools 440 979 8. Annual admissions in medical colleges 26,449

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9. Dental colleges 205 10 Allopathic doctors 767,500 11 Nurses 865,135 12 ANMs 506,925 13 Health visitors 50,393 14 Health workers(f) 133,194 15 Health workers (m) 61,907 16 Block extension educator 2,645

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17 Health assistant male 20,181 18 Health assistant female 17,371 19 Village health guides 3.23 Lakh 20 Infant Mortality Rate 34.61/1000 21 Maternal Mortality Rate 4.5/1000 22 Literacy Rate

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SUMMARIZATION

CONCLUSION:

CONCLUSION Targets of the tenth five year plan reflect the concern that economic growth alone may not lead to the attainment of long term sustainability and of adequate improvement in social justice . Earlier plans have had many issues as objectives, but in number of cases specific targets were set . As a result, there were viewed in terms of being desirable but not essential . In the 10th plan, these targets were considered to be as central to the planning framework as the growth objective. During tenth plan there was continued commitment to provide essential primary care, emergency life saving services, serves under National disease control programme free of cost to individuals, based on their needs, and not on their ability to pay.

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BIBLIOGRAPHY

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BOOKS Basavanthappa B.T. “Community Health Nursing” 2 nd Edition 2008, Paras Offset Pvt. Ltd., New Delhi, Jaypee , Pp 889-894 Gupta Mc , Mahajan BK’s “ Textbook of Preventive and Social Medicine” 3 rd Edition2005, New Delhi, Jaypee Publishers, Pp 434-437 Kishore J’s “ National Health Programmes of India- National Policies and Legislations Relatedto Health” 7 th Edition,2007, New Delhi, Century Publication, Pp50-53 Park K. “ Textbook of Preventive and Social Medicine” 19 th Edition 2007, Premnagar, Jabalpur, M/S Banarasidas Bhannot Pp 728-729 Piyush Gupta, Ghai O.P.’s “ Textbook of Preventive and Social Medicine” 2 nd Edition 2007, New Delhi ,CBS Publishers & Distributers, Pp 743-744 JOURNALS Indian Nursing Journal Book 2002-2004, Pp33-40 Nightingale Nursing Times, November 05, Pp 41-43 NEWSPAPER THE HINDU NEWSPAPER, Tenth Five Year Plan, Saturday, Oct 12, 2002 THE TIMES OF INDIA, INDIA BUSINESS, Highlights of the 10th Five-Year Plan, 21 December 2002. INTERNET http://en.wikipedia.org/wiki/Five-year_plans_of_India)Tenth plan (2002-2007 http://www.associatedcontent.com/article/1496755/the_tenth_fiveyear_plan_in_india.html